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T Terada

Publications and source records attributed to T Terada.

At least 379 records · Page 21Linked to original sources
PubMed1991

[Primary testicular carcinoid tumor with teratoma: a case report].

We report a case of primary testicular carcinoid with teratoma and review the literature. A 68-year-old man was hospitalized with an asymptomatic left testicular mass. Left radical orchiectomy was performed under a diagnosis of testicular tumor. Histologically, the tumor showed a typical appearance of teratoma with carcinoid components. Barium studies, computed tomographic scan could not demonstrate any other tumor anywhere else. He is now being followed at our clinic without any evidence of recurrence.

Aged↗
PubMed1991

HLA-DR expression on the microvasculature of portal tracts in idiopathic portal hypertension. Immunohistochemical characteristics and relation to portal phlebosclerosis.

We recently reported that HLA-DR antigen was expressed on the microvasculature of portal tracts more frequently in idiopathic portal hypertension (IPH) than in normal livers or in other hepatic diseases, and that this HLA-DR expression may be involved in the development of the portal venopathy characteristic of IPH. The present study was performed to evaluate the relationship between the HLA-DR expression and portal tract lesions, as well as to investigate the immunohistochemical characteristics of the HLA-DR-positive microvasculature using liver wedge biopsy specimens obtained from 32 patients with IPH. According to the degree of phlebosclerosis of the portal veins, the portal tracts were divided into three groups: mild, moderate, and severe. The microvasculature in portal tracts was positive for HLA-DR in 21 (66%) of the 32 specimens and in 133 (44%) of 302 portal tracts. In the 21 specimens, there was no significant difference in the prevalence of HLA-DR-positive microvasculature among the three groups: it occurred in 57 (66%) of 86 portal tracts in the mild group, 53 (61%) of 87 portal tracts in the moderate group, and 23 (49%) of 47 portal tracts in the severe group. The HLA-DR-positive microvasculature was positive for type IV collagen and receptors of Ulex europaeus lectin I, suggesting that HLA-DR-positive microvessels are blood vessels. These findings suggest that HLA-DR antigen is already expressed on portal microvessels in the incipient stage of IPH, and that HLA-DR expression persists during the progression of portal phlebosclerosis. The HLA-DR expression may be an initiating factor leading to immunologic assault on portal microvessels in IPH.

Aged↗
PubMed1991

[Magnetic resonance imaging in neuro-Behçet's disease--comparison with clinical, X-ray CT, and PET findings].

Magnetic resonance imaging (MRI) examinations of 23 patients with neuro-Behçet's disease were evaluated to correlate the results with clinical, X-ray CT, and positron emission tomography (PET) findings. The results were as follows: Focal lesions were detected in 17 (73.9%) and brain atrophy was depicted in 10 (43.4%) out of the 23 patients. This ratio was higher than X-ray CT. The acute phase lesions detected by MRI at the first medical examination were diminished after the treatment in proportion to the improvement of the clinical symptoms. Cerebral blood flow study and glucose metabolism study by PET were performed on patients whose main problems were mental symptoms. Both cerebral blood flow and glucose metabolism were decreased in these patients. These results suggest that MRI is a useful technique for detecting the central nervous system lesions of neuro-Behçet's disease and monitoring its clinical status and therapeutic response for this disease, and PET provides a useful way of understanding the haemocirculatory and metabolic aspects of this disease.

Adult↗
PubMed1991

Intrahepatic biliary papillomatosis arising in nonobstructive intrahepatic biliary dilatations confined to the hepatic left lobe.

Papillomatosis of intrahepatic bile ducts is a rare pathologic entity. We describe herein a case of papillomatosis of intrahepatic bile ducts associated with nonobstructive dilatations of intrahepatic bile ducts of the hepatic left lobe. The patient, a 70-yr-old female, complained of right upper abdominal pain. Cholangiograms revealed multiple cystic dilatations of the left intrahepatic bile ducts. The right intrahepatic bile ducts were almost normal. The patient underwent left lobectomy of the liver. Grossly, intrahepatic bile ducts of the left lobe were cystically dilated and contained a little mucinous fluid. The inner surface of the dilated ducts was mildly granular or papillary. Microscopically, the walls of the dilated intrahepatic ducts were diffusely covered by columnar epithelial cells with papillary configurations. There was mild atypia of the epithelial cells, but no invasion of the epithelial cells into underlying duct walls was found. To the best of our knowledge, this is the first case of papillomatosis of intrahepatic bile ducts associated with nonobstructive dilatations of intrahepatic bile ducts confined to the left lobe. Although the pathogenesis of intrahepatic biliary papillomatosis of our case is unclear, it seems conceivable that biliary irritation associated with the nonobstructive dilatations of intrahepatic bile ducts is causally related to the papillary proliferations of intrahepatic bile duct epithelial cells.

Aged↗
PubMed1991

Immunohistochemical demonstration of pancreatic alpha-amylase and trypsin in intrahepatic bile ducts and peribiliary glands.

Epithelia of intrahepatic bile ducts and peribiliary glands were immunohistochemically examined for pancreatic alpha-amylase and trypsin in 54 normal autopsied livers. alpha-Amylase was evaluated with a polyclonal antibody, and trypsin was assayed with both polyclonal and monoclonal antibodies. alpha-Amylase was observed in large ducts, septal ducts and peribiliary glands in most livers and was seen in interlobular ducts in seven (13%) livers. Trypsin immunoreactivity with the polyclonal antibody was observed in peribiliary glands in 21 (39%) livers; it was absent in intrahepatic bile ducts in all but one liver. Trypsin immunoreactivity with the monoclonal antibody was present in large ducts, septal ducts and peribiliary glands in about 70% of the livers and was seen in interlobular ducts in two (4%) livers. Bile ductules were always negative for the two antigens. Some epithelia of peribiliary glands positive for both alpha-amylase and trypsin histologically resembled pancreatic acinar cells. alpha-Amylase and trypsin immunoreactivities of intrahepatic biliary epithelia and pancreatic aninar cells were eliminated by absorption of primary antibodies by alpha-amylase or trypsin, suggesting the specificities of the immunoreactivities. These data suggest that epithelia of intrahepatic large ducts, septal ducts and peribiliary glands contain pancreatic alpha-amylase in most livers and that they contain trypsin in about 70% of livers. alpha-Amylase and trypsin may be secreted into intrahepatic bile duct lumens, thereby exerting important effects on the physiology of the intrahepatic biliary tree and hepatic bile.

Adult↗
PubMed1991

Expression of HLA-DR antigen on hepatic vascular endothelial cells in idiopathic portal hypertension.

Immunologic abnormalities have been reported in idiopathic portal hypertension, though the exact immunologic mechanism(s) leading to various portal venopathies in this disease remain unsettled. Recently, aberrant expression of HLA-DR antigen on target cells has been noted in the organ-specific autoimmune diseases. In this study the expression of HLA-DR antigen on the hepatic vasculature was surveyed immunohistochemically in idiopathic portal hypertension (n = 36) and in control livers: normal livers (n = 27), chronic active hepatitis (n = 35) and cirrhosis (n = 21). Endothelial cells of hepatic veins and hepatic arteries occasionally expressed HLA-DR antigen, and there was no difference in the expression between idiopathic portal hypertension and controls. Endothelial cells of the main portal vein, within the small and medium-sized portal tract, did not express HLA-DR antigen in idiopathic portal hypertension and controls. By contrast, endothelial cells of the smaller venous radicles, including inlet venules in these portal tracts other than the main portal vein, more frequently expressed HLA-DR antigen in idiopathic portal hypertension (78%) than in chronic active hepatitis (26%), cirrhosis (29%) and normal liver (15%). These data raise the possibility that the smaller venous radicles in the small and medium-sized portal tracts are targets of immunologic attack in idiopathic portal hypertension.

Adult↗
PubMed1991

[Case report: a foreign body (gauze) in the bladder].

A case of bladder tamponade caused by a foreign body (gauze) in the bladder of a 24-year-old man is reported. He had been treated with the Lambotte wire and screw to repair his pubic bone fracture caused by a traffic accident. About one year later, the wire and screw were removed from the patient. However, he suffered from gross hematuria and bladder tamponade on the 11th day after the 2nd operation, and he was transferred to our outpatient department on emergency. Further urological examinations were done for this case. The patient was diagnosed as having bladder tamponade caused by a foreign body, a gauze, in the bladder. Among these examinations NMR-CT gave us the most interesting and useful findings. NMR-CT showed that the gauze penetrated the bladder wall.

Adult↗
PubMed1990

Iron-accumulating adenomatous hyperplastic nodule with malignant foci in the cirrhotic liver. Histopathologic, quantitative iron, and magnetic resonance imaging in vitro studies.

Five iron-accumulating adenomatous hyperplastic nodules (AHN) in cirrhotic livers were examined histologically, by quantitation of tissue iron, and by magnetic resonance imaging (MRI) in vitro. Histologically, one AHN was benign, while the other four contained malignant hepatocellular foci. Iron staining and quantitation of tissue iron revealed that AHN were rich in iron, but the malignant hepatocellular foci and surrounding regenerative nodules were relatively poor in iron. The MRI showed that AHN were hypointense while malignant hepatocellular foci and surrounding regenerative nodules were isointense. Thus, malignant hepatocellular foci within AHN corresponded to iron-poor isointense foci. These findings suggest that malignant hepatocellular foci arising in iron-accumulating AHN are resistant to iron accumulation and that iron-accumulating AHN can be recognized with MRI in vitro as hypointense and malignant foci as isointense.

Aged↗
PubMed1990

Hepatocellular carcinoma in primary biliary cirrhosis: an autopsy study.

A survey of Japanese autopsy cases of primary biliary cirrhosis disclosed that hepatocellular carcinoma is apparently becoming a better recognized complication of the advanced stage of primary biliary cirrhosis. Six autopsy cases (five women and one man) of primary biliary cirrhosis associated with hepatocellular carcinoma were obtained from several Japanese institutions and examined. All cases were in an established cirrhotic stage of primary biliary cirrhosis. Hepatocellular carcinoma was incidentally found at autopsy in four cases and, in these, the carcinomas were small in size and number. The other two cases showed advanced hepatocellular carcinoma and one case showed extrahepatic metastasis. Histologically, all cases showed well-differentiated hepatocellular carcinomas. Fatty changes or bile plugs were frequently seen within the tumors. Mallory body clusters and focal deposition of copper-binding protein were consistently found in cirrhotic liver tissues and also in the carcinoma tissues of almost all cases. The presence of atypical adenomatous hyperplasia in the peripheries of some carcinomas suggested that hepatocellular carcinoma in primary biliary cirrhosis may evolve through multiple steps.

Carcinoma, Hepatocellular↗
PubMed1990

Pathological observations of intrahepatic peribiliary glands in 1,000 consecutive autopsy livers. II. A possible source of cholangiocarcinoma.

It remains unclear whether atypical epithelial lesions, including carcinomas and precancerous lesions, develop in intraheptic peribiliary glands. This question was tested in this study. One thousand livers from consecutive autopsies were surveyed and 201 livers with bile duct carcinomas or metastatic malignant neoplasms were excluded because atypical epithelial lesions of the glands were difficult to distinguish from the primary or metastatic malignant cells. Consequently, 799 livers were examined for the atypical epithelial lesions by histological, mucin-histochemical and immunohistochemical methods. The atypical epithelial lesions were divisible into papillary hyperplasia, atypical hyperplasia and carcinomatous transformation. Of the 799 livers, papillary hyperplasia was only found in six livers (0.8%), papillary hyperplasia and atypical hyperplasia coexisted in four livers (0.5%) and carcinomatous transformation and atypical hyperplasia coexisted in one liver (0.1%). Mucin-histochemical study showed that the intracytoplasmic location of mucin was different between carcinomatous transformation and normal peribiliary glands. From an immunohistochemical standpoint, epithelial cells of the atypical epithelial lesions showed stronger immunoreactivities to carcinoembryonic antigen, carbohydrate antigen 19-9 and DU-PAN-2 than those of normal intrahepatic peribiliary glands. These findings suggest that intrahepatic cholangiocarcinomas arising from intrahepatic peribiliary glands actually exist, and that papillary and atypical hyperplasia of the peribiliary glands may precede this type of cholangiocarcinoma.

Adenoma, Bile Duct↗
PubMed1990

Amyloid deposition in intrahepatic large bile ducts and peribiliary glands in systemic amyloidosis.

Amyloid deposition in the hepatic parenchyma and portal tracts in the liver is well known in systemic amyloidosis. We recently experienced an autopsy case of systemic amyloidosis presenting the amyloid deposits in the intrahepatic biliary tree. This experience prompted us to survey 19 autopsy cases of systemic amyloidosis. Amyloid deposition was found just under the lining epithelium of the intrahepatic large bile duct in 10 of 19 cases and around the peribiliary glandular acini in 7 of the 19 cases, respectively. Amyloid deposition in the intrahepatic large bile duct and peribiliary glands was positively correlated with the degree of amyloid deposition in the liver but not with type of amyloid protein. Double-staining of amyloid and vascular endothelium disclosed that amyloid deposition was more closely related to the inner part of the peribiliary vascular plexus and to the vascular plexus encircling the peribiliary glands than the lining biliary epithelium and peribiliary glandular acinar cells themselves. The exact pathogenesis of amyloid deposition in these anatomical components, however, remains unclear. Although our cases failed to show any overt clinical symptomatologies related to amyloid deposition in these biliary components, it seems conceivable that more massive amyloid deposition in these anatomical components could give rise to some clinical symptoms.

Amyloid↗
PubMed1990

Pathological observations of intrahepatic peribiliary glands in 1,000 consecutive autopsy livers. III. Survey of necroinflammation and cystic dilatation.

Pathological changes and significance of intrahepatic peribiliary glands, hitherto poorly recognized intrahepatic elements, have been evaluated in our laboratory. In this report, we surveyed necroinflammatory and cystic changes of the peribiliary glands in 1,000 consecutive autopsy livers because these two changes coexisted frequently in the same liver. The necroinflammatory change was found in 228 livers (22.8%) and the cystic change in 202 livers (20.2%), and 103 cases showed both changes in the same liver. The necroinflammatory change was frequently found in intrahepatic cholangitis and extrahepatic biliary obstruction with bacterial infection, suggesting that biliary bacterial inflammation extends into these peribilary glands. This change was also frequent in systemic infection or septicemia without biliary bacterial infection, implying that the peribiliary glands were also damaged in such conditions without direct infection. The cystic change was frequent in livers with portal hypertension or obstruction, adult polycystic disease and necroinflammation of the glands, suggesting that the cystic change of the glands could occur as the result of the disturbance of intrahepatic circulation or as the result of inflammatory destruction of the glandular conduits. Some of peribiliary cysts may be of congenital origin. Dysfunction related to these pathological changes in the glands may diminish seromucous secretion and cause alterations in hepatic bile composition. The cystic change of the glands may retard bile flow by compressing bile duct lumina.

Bile Duct Diseases↗
PubMed1990

Assessment of risk of carotid occlusion with balloon Matas testing and dynamic computed tomography.

Temporary occlusion of the internal carotid artery with a balloon catheter (balloon Matas test) and simultaneous dynamic computerized tomography scanning (DCT) were performed to determine the tolerance of permanent carotid occlusion in eight cerebral aneurysm and two carotid-cavernous fistula (CCF) cases, in whom internal carotid occlusion might be necessary during operation or as a choice of treatment. All patients were evaluated by mean transit time (MTT), especially % transit time (MTT of the occluded side x 100/MTT of the control side). In six patients, % transit time (%TT) was less than 155 and no neurological signs appeared after permanent internal carotid occlusion. Neurological deficit appeared when mean arterial blood pressure was 80, and disappeared when mean arterial blood pressure was 100 during the balloon Matas test in a case whose %TT was 200. Neurological deficit appeared several seconds after the balloon Matas test in a case whose %TT was 250. The critical %TT value to cause symptomatic ischaemia was 200 from our results. Therefore, it is necessary to undertake treatment such as bypass surgery for the patients whose %TT is near 200, even if the balloon Matas test was negative.

Aged↗
PubMed1990

Volume change of the prostate and seminal vesicles in male hypogonadism after androgen replacement therapy.

Before and after androgen replacement therapy prostatic and seminovesicular volume was estimated by means of transrectal ultrasonography in 13 hypogonadal men. Volume of the prostate (p less than 0.001) and seminal vesicles (p less than 0.01) significantly increased after treatment with testosterone enanthate. However, the plasma level of testosterone remained abnormally low. These results indicate that volume determination of the prostate and seminal vesicles by means of transrectal ultrasonography is suitable for evaluating the adequacy of androgen replacement therapy in male hypogonadism.

Adult↗
PubMed1990

Pathologic observations of intrahepatic peribiliary glands in 1000 consecutive autopsy livers. Heterotopic pancreas in the liver.

One thousand consecutively autopsied livers were examined for intrahepatic heterotopic pancreas. Heterotopic pancreas in the liver was found in 41 (4.1%) of the 1000 livers. It occurred with nearly equal frequency in "normal" livers and variously diseased livers. Histologically, heterotopic pancreas was situated exclusively in the large- and medium-sized portal tracts, and its size ranged from 250-900 microns in diameter. It was intermingled with intrahepatic peribiliary glands and appeared to communicate with bile duct lumina. Heterotopic pancreas consisted of three cell types: acinar cells with eosinophilic zymogenlike granules, clear cells resembling centriacinar cells, and ductular elements. Langerhans' islets were not found in any cases. Immunohistochemically, constituent cells of heterotopic pancreas contained pancreatic alpha-amylase and trypsin but lacked argentaffin and argyrophilic cells as well as insulin-, glucagon-, and somatostatin-immunoreactive endocrine cells. Ultrastructurally, acinar cells contained many dense granules regarded as zymogen granules. It is indicated that intrahepatic heterotopic pancreas occurs in large portal tracts. It may modify hepatic bile by secreting pancreatic enzymes into intrahepatic bile duct lumina.

Adolescent↗
PubMed1990

Mapping of cavernous vessels in the liver in an autopsy case of hepatocellular carcinoma in comparison with imaging figures.

Cavernous vessels in the liver have been rarely described in the liver with hepatocellular carcinoma. We report the morphology and distribution of cavernous vessels in an autopsy liver of hepatocellular carcinoma, using a whole liver slice. In this case, antemortem angiography disclosed obstruction of portal veins at the hepatic hilus and portal trunk as well as many hepatopetal collaterals, mainly at the hepatic hilus. Tumor thrombi were diffusely distributed in the liver from the portal trunk to peripheral portal branches at autopsy. The cavernous vessels, which were positive for Factor VIII-related antigen, were also distributed throughout the liver from the hepatic hilus to the subcapsular regions, especially around the occluded portal veins by hepatocellular carcinoma, suggesting that these vessels were collaterals that developed as the result of portal obstruction. This study suggests that these vessels might be present from the hepatic hilus to the subcapsular regions, even if antemortem imaging techniques disclose collateral vessels only at the hepatic hilus.

Autopsy↗